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Step 1 2019 First Aid Flashcards > Psych - FA p542 - 559 > Flashcards

Psych - FA p542 - 559 Flashcards

1
Q

After burning his fingers 3x by touching the candle, little Joe learned never to touch fire again. What type of conditioning is that?

A

Punishment

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2
Q

Child finishes up his “yucky” veggis to be able to get ice-cream after. What type of conditioning is that?

A

Positive reinforcement

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3
Q

T or F? Classical conditioning is a permissive response.

A

F. it is involuntary

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4
Q

Operant conditioning is the opposite of —.

A

Classical conditioning

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5
Q

Guantanamo prisoner pleaded guilty after being Waterboarded for 2 hours. What type of conditioning is that?

A

Negative reinforcement “use of neg force”

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6
Q

— can occur in operant or classical conditioning.

A

Extinction (you can cut the link btw stimulus and behavior)

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7
Q

First yr resident yells at a med student, because her attending physician yelled at her earlier about her bedside manners.

A

Displacement

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8
Q

Fixation can be mistaken for —. compare them.

A

regression–>Turning back the maturational clock. Seen in children under stress such as illness, punishment, or birth of a new sibling Fixation–>Partially remaining at a more childish level of development. Adult playing video games.

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9
Q

— is when patient reminds physician of younger sibling.

A

Countertransference

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10
Q

A child wears his hat backwards bc he sees his favorite actor do it on television

A

Identification –> Modeling behavior after another person who is more powerful (though not necessarily admired).

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11
Q

Temporary, drastic change in motor behavior to avoid emotional stress is called?

A

Dissociation

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12
Q

Student who hates geography is repeatedly late for class and performs below average on tests.

A

Passive Aggression

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13
Q

A student who wants to cheat on an exam thinks his classmates are doing the same.

A

Projection

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14
Q

Physician describing in graphic detail with no emotional response the death of murdered pt. Is the physician’s behavior a mature or immature defense mechanism?

A

Isolation, Immature

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15
Q

An alcoholic pt becomes the speaker of the AA group.

A

Reaction Formation

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16
Q

T or F? Repression is voluntarily withholding an idea or feeling from conscious awareness.

A

F. Involuntary

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17
Q

Husband’s aggression toward his wife is redirected to perform well at his job. Mature or immature defense mech?

A

Sublimation;mature

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18
Q

A physician chooses to not worry about having acquired HIV from a needle prick until the actual test results are positive.

A

Suppression

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19
Q

Long term deprivation of affection in infants result in

A
  • failure to thrive,
  • poor language/social skills
  • lack of basic trust,
  • reactive attachment disorder (infant withdrawn & unresponsive to comfort)
  • Disinhibited social engagement (child indiscriminately attaches to strangers)
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20
Q

what is the time frame for irreversible changes in deprivation in an infant

A

> 6months and severe deprivation can lead to infant death

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21
Q

in child abuse who is the abuser in physical abuse and who is the abuser in sexual abuse, most often

A

biological mother (physical) Known to victim, usual male (sexual)

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22
Q

what is the most common form of child maltreatment

A

Child neglect

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23
Q

when a parent perceives a child as susceptible to illness and injury, which can result to missed school or overuse of medical services - what is this called?

A

Vulnerable child syndrome

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24
Q

limited attention span, normal intelligence and poor impulse control refers to

A

attention deficit hyperactivity disorder

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25
Q

treatment for attention deficit hyperactivity disorder

A

methylphenidate, cognitive behavior therapy, atomoxetine, guanfacine, clonidine

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26
Q

what disorder is associated with increase head/brain size and common in boys

A

Autism

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27
Q

what is the Mode of inheritance for Rett syndrome and what gender is affected most

A

X linked dominant & girls

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28
Q

stereotyped hand-wringing is associated with ———

A

Rett syndrome

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29
Q

repetitive behavior violating the basic rights of others or social norms and destruction of property is associated with

A

conduct disorder/antisocial disorder

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30
Q

Treatment of conduct and antisocial disorder

A

Psychotherapy such as CBT

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31
Q

Enduring pattern of hostile, defiant behavior toward authority gures in the absence of serious violations of social norms refers to

A

Oppositional defiant disorder

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32
Q

Overwhelming fear of separation from home or loss of attachment figure refers to

A

Separation anxiety disorder

normal behavior up age 3-4

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33
Q

17 year old male Characterized by sudden, rapid, recurrent, nonrhythmic, stereotyped motor and vocal tics that persist for > 1 year is what path

A

Tourette syndrome (onset before 18yrs)

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34
Q

what are the association and Tx for Tourette syndrome

A

Associated with OCD and ADHD. TX psychoeducation, behavioral therapy. For intractable tics, low-dose high-potency antipsychotics (e.g., fluphenazine, pimozide), tetrabenazine, and clonidine may be used.

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35
Q

what are the neurotransmitter changes in Alzheimer disease

A

dec  ACh inc glutamate

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36
Q

what are the neurotransmitter changes in anxiety

A

inc NE, Dec Gaba, 5-HT

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37
Q

neurotransmitter changes in Huntington disease

A

dec Gaba, ach inc dopamine

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38
Q

what are the neurotransmitter changes in schizophrenia

A

Inc Dopamine

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39
Q

Causes of Loss of Orientation

A

alcohol, drugs, fluid/electrolyte imbalance, head trauma, hypoglycemia, infection, nutritional deficiencies, hypoxia

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40
Q

list the order of orientation loss

A

Order of loss: 1st—time; 2nd—place; last— person.

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41
Q

Inability to remember things that occurred before a CNS insult.

A

Retrograde amnesia

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42
Q

Inability to remember things that occurred after a CNS insult ( dec acquisition of new memory)

A

Anterograde amnesia

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43
Q

Amnesia (anterograde > retrograde) caused by vitamin B1 de ciency and associated destruction of mammillary bodies. Seen in alcoholics. Confabulations are characteristic.

A

Korsakoff syndrome

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44
Q

what is Dissociative amnesia

A

Inability to recall important personal information, usually subsequent to severe trauma or stress. May be accompanied by dissociative fugue (abrupt travel or wandering during a period of dissociative amnesia, associated with traumatic circumstances).

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45
Q

Characterized by disorganized thinking, hallucinations (often visual), illusions, misperceptions, disturbance in sleep- wake cycle, cognitive dysfunction.

A

Delirium

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46
Q

————is characterized by irreversible memory loss.

A

Dementia

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47
Q

what type of hallucination occurs while going to sleep. Sometimes seen in narcolepsy.

A

Hypnagogic

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48
Q

Occurs while waking from sleep and sometimes seen in narcolepsy

A

Hypnapompic

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49
Q

what type of hallucination is associated with the sensation of bugs crawling on one’s skin; where is it seen?

A

tactile seen in alcoholic withdrawer and cocaine abuse

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50
Q

hallucination & delusion longer than 6 months is seen in

A

Schizophrenia

51
Q

what are the positive symptoms of schizophrenia (4)

A
  • hallucinations,
  • delusions,
  • unusual thought processes,
  • disorganized speech,
  • bizarre behavior
52
Q

what are the negative symptoms of schizophrenia

A
  • flat or blunted affect,
  • apathy,
  • anhedonia,
  • alogia,
  • social withdrawal
53
Q

hallucination lasting less than 1month

A

Brief psychotic disorder

54
Q

hallucination lasting 1-6 months

A

schizophreniform

55
Q

lasting > 2 weeks; psychotic symptoms with episodic superimposed major depression or mania (or both). Psychosis is present with and without mood disorder, but mood disorder is present only with psychosis refers to

A

Schizoaffective disorder

56
Q

long term deprivation of affection in infants result in

A

ƒ Failure to thrive ƒ Poor language/socialization skills ƒ Lack of basic trust ƒ Reactive attachment disorder (infant withdrawn/unresponsive to comfort) ƒ Disinhibited social engagement (child indiscriminately attaches to strangers)

57
Q

a woman who genuinely believes she is married to a celebrity when, in fact, she is not is what disorder?

A

Delusional disorder

Daily functioning, including socialization, may be impacted by the pathological, fixed belief but is otherwise unaffected. Can be shared by individuals in close relationships (folie à deux).

58
Q

list 6 things that associates with Dissociative identity disorder

A

history of sexual abuse, PTSD, depression, substance abuse, borderline personality, somatoform conditions.

59
Q

what disorder is associated with persistent feelings of detachment or estrangement from one’s own body, thoughts, perceptions, and actions

A

Depersonalization/ derealization disorder

60
Q

DIGFAST which is used for diagnosis and hospitalization in manic episode stands for?

A

ƒ Distractibility
ƒ Impulsivity/Indiscretion—seeks pleasure without regard to consequences (hedonistic)
ƒ Grandiosity—inflated self-esteem
ƒ Flight of ideas—racing thoughts ƒ
 goal-directed Activity/psychomotor Agitation
 dec need for Sleep
ƒ Talkativeness or pressured speech

61
Q

what is hypomanic episode

A

Like manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization. No psychotic features. Lasts at least 4 consecutive days.

62
Q

what is the time frame for irreversible changes in deprivation in an infant

A

> 6months and severe deprivation can lead to infant death

63
Q

of Days to qualify as hypomanic episode?

A

Last at least 4 consecutive days

64
Q

What makes a hypomanic episode diff from a manic episode?

A

Similar to a manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization. No psychotic features.

65
Q

Diff between Bipolar I and II

A

Bipolar I defined by presence of at least 1 manic episode +/− a hypomanic or depressive episode. Bipolar II defined by presence of a hypomanic and a depressive episode.

66
Q

Drugs that can ppt mania?

A

Use of antidepressants can destabilize mood.

67
Q

Tx for Bipolar disorder?

A

Treatment: mood stabilizers (eg, lithium, valproic acid, carbamazepine), atypical antipsychotics.

68
Q

Minimal duration of cyclothymic disorder?

A

Must last ≥ 2 years with symptoms present at least half of the time, with any remission lasting ≤ 2 months

69
Q

How long do major depressive episodes last?

A

Episodes characterized by ≥ 5 of the 9 diagnostic symptoms lasting ≥ 2 week

70
Q

What symptoms are included to Dx Major Depressive disorders?

A

SIG E CAPS: ƒƒDepressed mood ƒƒ Sleep disturbance ƒƒ Loss of Interest (anhedonia) ƒƒGuilt or feelings of worthlessness ƒƒ Energy loss and fatigue ƒƒConcentration problems ƒƒ Appetite/weight changes ƒƒ Psychomotor retardation or agitation ƒƒ Suicidal ideations

71
Q

__#__ Sx out of __#__ ttl Sx for ____ (length of time) for diagnose Major Depressive Disorder?

A

Episodes characterized by at least 5 of the following 9 symptoms for 2 or more weeks

72
Q

1st line Tx for Major Depressive Disorder?

A

CBT and SSRIs

73
Q

2nd line Tx for Major Depressive Disorder?

A

SNRIs, mirtazapine, bupropion can also be considered.

74
Q

Persistent depressive disorder

A

depression, often milder, lasting at least 2 years.

75
Q

Changes in sleep in patients with Depression?

A

ƒƒ  slow-wave sleep ƒƒ  REM latency ƒƒ  REM early in sleep cycle ƒƒ  total REM sleep ƒƒ Repeated nighttime awakenings ƒƒ Early-morning wakening (terminal insomnia)

76
Q

What makes depression atypical?

A

Characterized by mood reactivity (predominantly depression, but patients have the ability to experience transient mood improvement in response to positive events),

  • hypersomnia,
  • hyperphagia,
  • leaden paralysis (heavy feeling in arms and legs),
  • long-standing interpersonal rejection sensitivity
77
Q

Sx of postpartum psychosis?

A

Characterized by mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.

78
Q

Most common method to commit suicide? Are men or women more likely to commit suicide?

A

Most common method in US is firearms, Women attempt suicide more often, men tend to succeed with it.

79
Q

Symptoms of Panic attack?

A

PANICS

Palpitations, Paresthesias, dePersonalization or derealization, Abdominal distress or Nausea, Intense fear of dying, Intense fear of losing control or “going crazy,” lIght-headedness, Chest pain, Chills, Choking, Sweating, Shaking, Shortness of breath (“P3AN[ICS]3”).

80
Q

How to treat a specific phobia?

A

Can be treated with systematic desensitization. ** NOTE - Patient does recognize that fear is excessive

81
Q

Define Gen anxiety disorder

A

Excessive anxiety and worry about different aspects of daily life (eg, work, school, children) for most days of ≥ 6 month

82
Q

How is adjustment disorder different from Gen anxiety disorder?

A

If symptoms persist > 6 months after stressor ends, it is GAD

83
Q

How is OCD different from OC personality disorder?

A

Ego-dystonic: behavior inconsistent with one’s own beliefs and attitudes vs the personality disorder where the it is consistent

84
Q

Acute stress disorder v Post traumatic stress disorder?

A

Acute - lasts between 3 days and 1 month. PTSD - lasts longer >1 mo

85
Q

Malingering

A

Patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to **attain a specific 2° (external) gain** (eg, avoiding work, obtaining compensation). Poor compliance with treatment or follow-up of diagnostic tests.

86
Q

Difference between factitious disorder and malingering?

A

Complaints in malingering cease after gain obtained (vs factitious disorder).

87
Q

Patient consciously creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attention

A

Factitious disorder

88
Q

Difference between malingering and somatic symptoms?

A

Malingering may be unconcious, but it is fabricated or exagerrated symptoms. Somatic illness and motivation are entirely unconscious, but not intentionally produced or feigned

89
Q

Loss of sensory or motor function (eg, paralysis, blindness, mutism), often following an acute stressor; patient is aware of but sometimes indifferent toward symptoms

A

Conversion disorder

90
Q

Excessive preoccupation with acquiring or having a serious illness, often despite medical evaluation and reassurance;

A

Illness anxiety disorder

91
Q

False, nondelusional belief of being pregnant. May have signs and symptoms of pregnancy but is not pregnant.

A

Pseudocyesis

92
Q

Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning, person is usually not aware of problem (ego-syntonic)

A

Personality disorder

93
Q

Difference between Schizoid vs Schizotypal?

A

SchizOiD - alOne and Distant - likes to be alone and is fine with it. Schizotypal - look for eccentric appearence or odd/magical thinking.

94
Q

Which B cluster personality disorder is associated with males?

A

Antisocial

95
Q

What differentiates antisocial personality disorder from conduct disorder?

A

Age - Antisocial personality disorder must be ≥ 18 years old and have history of conduct disorder before age 15. Diagnosis is conduct disorder if < 18 years old.

96
Q

Which cluster B disorder is associated with females?

A

Borderline

97
Q

self-mutilation, suicidality, sense of emptiness; females > males

A

Borderline

98
Q

Most common defense mech of borderline? and define it

A

Splitting

99
Q

sexually provocative, overly concerned with appearance.

A

Histrionic

100
Q

Grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; often demands the “best” and reacts to criticism with rage

A

Narcissistic

101
Q

Difference between avoidant and shizoid?

A

Avoidant desires relationships with others but is alone, Schizoid perfectly happy with being alone

102
Q

People of this personality type tend to get involved in abusive relationships?

A

Dependent - Submissive and clingy, excessive need to be taken care of, low self-confidence

103
Q

what is the refeeding syndrome?

A

When reintroducing food to an anorexic, the inc in insulin –> hypophosphatemia, hypokalemia, hypomagnesemia –> cardiac complications, rhabdomyolysis, seizures.

104
Q

what type of stress fractures you see in anorexia nervosa?

A

Metatarsal stress fracture

105
Q

which eating disorder is the one with normal body weight

A

bulimia nervosa

106
Q

what is Russell sign

A

dorsal hand calluses from induced vomiting

107
Q

Narcolepsy is associated with a decrease in what? where is it produced?

A

Caused by dec in Hypocretin (orexin); produced in lat HT

108
Q

Night time treatment of narcolepsy

A

Sodium oxybate

109
Q

what is varenicline and where is it used?

A

for nicotine withdrawal its a partial agonist of nicotinic AchR

110
Q

Pick out the drugs (when intoxicated) that can cause mydriasis 1. Alcohol 2. Opioids 3. Barbs and BDZ 4. Amphetamine 5. Cocaine 6. PCP 7. LSD 8. Marijuana

A

Amphetamine and Cocaine, Marijuana

111
Q

treatment of cocaine intox, and what would you have to avoid?

A

benzodiazepines; consider mixed α-/β-blocker (eg, labetalol) for hypertension and tachycardia

No pure BB

112
Q

What drug do you go “cold turkey” with? What does that mean?

A

Opiod withdrawal, piloerection of skin

113
Q

Opiods Tx for intoxication and withdrawal

A

intox: naloxone, naltrexone withdrawal: methadone, buprenorphine

114
Q

which opioid antagonist is not orally available so withdrawal symptoms occur only if IV, so lower abuse potential

A

Nalaxone

115
Q

why do you use clonidine for opioid withdrawal?

A

alpha2 agonist

116
Q

List 3 symptoms of PCP intoxication

A
  1. Aggression (Belligerence) 2. Vertical + horizontal nystagmus 3. Acute brain syndrome (disorient, poor judgement, memory loss)
117
Q

College student at rave party comes in with symptoms of pyschosis. He said he sometimes find himself escaping from his body even though he is aware of everything around him. he is seeing color halos. what does he take?

A

LSD

118
Q

Patient with AIDS, complain of vomiting and decreased appetite. After given a certain drug, he comes back with dry mouth, impaired time perception and conjunctival injection. what is the name of the drug

A

Cannabinoids

119
Q

They are doing a urine test at your work, and you got high 2 weeks before. are you screwed?

A

yes MJ can be detected in urine up to 1 month

120
Q

Heroin relapsed prevention once you are clean

A

Naltrexone PO

121
Q

detox and maintenance of heroin

A

methadone full agonist! long acting

122
Q

triad of Wernicke encephalopathy

A

confusion, ophthalmoplegia, ataxia

123
Q

alcoholic withdrawal hallucinations: visual or auditory and how many hours after

A

visual 12-48 hrs after

Step 1 2019 First Aid Flashcards (63 decks)

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